Sekhon Lali H S
Department of Neurosurgery and Spinal Injuries Unit, Royal North Shore Hospital and University of Sydney, Sydney, New South Wales, Australia.
J Spinal Disord Tech. 2005 Feb;18 Suppl:S125-8. doi: 10.1097/01.bsd.0000117545.88865.b9.
This case report describes a 38-year-old-man who initially underwent a C5-C6 anterior cervical decompression and interbody fusion and plating for a right C6 radiculopathy. Within a few months of his surgery, he developed bilateral C7 radiculopathies, with imaging confirming adjacent segment foraminal stenosis. Repeat imaging suggested some subsidence of the original interbody graft but no overt pseudoarthrosis, and flexion/extension films showed no evidence of movement at the fused level. Six months after the original surgery, he underwent re-exploration. Decompression and arthroplasty were effected at the C6-C7 level. The old fusion was removed at the C5-C6 level and remobilized, and an arthroplasty was performed. At discharge, the patient's neck pain and hand symptoms had improved, and he had motion demonstrable on radiologic imaging at C5-C6. This is the first reported case of reversal of a cervical fusion with re-establishment of motion and represents an alternate acceptable management of pseudoarthrosis or recent spinal fusion.
本病例报告描述了一名38岁男性，其最初因右侧C6神经根病接受了C5 - C6颈椎前路减压、椎间融合及钢板固定术。术后数月，他出现双侧C7神经根病，影像学检查证实相邻节段椎间孔狭窄。复查影像学显示原椎间融合器有一定下沉，但无明显假关节形成，屈伸位X线片显示融合节段无活动迹象。初次手术后6个月，他接受了再次探查。在C6 - C7节段进行了减压和关节成形术。在C5 - C6节段移除了原融合物并使其松动，然后进行了关节成形术。出院时，患者的颈部疼痛和手部症状有所改善，且C5 - C6节段在影像学检查上有可显示的活动。这是首例报道的颈椎融合逆转并恢复活动的病例，代表了假关节或近期脊柱融合的另一种可接受的处理方法。
